小结
定义
痔垫组织是肛管内的正常解剖结构，通常位于左侧及右前及右后方。但痔垫增大时，可向肛管外突出并造成症状。[Figure caption and citation for the preceding image starts]: 胶圈套扎多余痔组织Kurt G. Davis, MD [Citation ends].
[Figure caption and citation for the preceding image starts]: 套扎位于位于齿状线以上Kurt G. Davis, MD [Citation ends].
病史和体格检查
关键诊断因素
- 存在的危险因素
- 直肠出血
- 间歇性脱出
- 肛周痛/不适
其他诊断因素
- 肛门瘙痒
- 疼痛性可触及的肛周病变
- 肛门包块
危险因素
- 年龄 45-65 岁之间
- 便秘
- 妊娠或盆腔占位病变
- 肝功能不全
- 腹水
诊断性检查
首要检查
- 肛镜检查
- 结肠镜/纤维乙状结肠镜
- 全血细胞计数 (FBC）
- 粪便隐血实验
治疗流程
就诊所有患者
橡皮圈套扎、硬化疗法、红外线凝结法、经肛门痔动脉结扎术或吻合器痔固定术等治疗失败
撰稿人
作者
Mohamed A. Thaha, PhD, FRCS (Gen Surg), PG Cert Hlt Econ
Senior Lecturer and Consultant in Colorectal Surgery
National Bowel Research Centre (NBRC)
Blizard Institute
Barts and The London School of Medicine & Dentistry
Queen Mary University of London
Colorectal & Pelvic Floor Services
Royal London Hospital
Barts Health NHS Trust
London
UK
利益声明
MAT declares that he has no competing interests.
Robert J.C. Steele, MD, FRCS
Professor of Surgery
Ninewells Hospital & Medical School
University of Dundee
Dundee
UK
利益声明
RJCS declares that he has no competing interests.
鸣谢
Dr Mohamed A. Thaha and Professor Robert J.C. Steele would like to gratefully acknowledge Dr Kurt G. Davis and Dr Jayan D. Jayasinghe, the previous contributors to this topic.
利益声明
KGD and JDJ declare that they have no competing interests.
同行评议者
George Reese, MB BS MRCS
Honorary Clinical Research Fellow
Division of Surgery
Oncology
Reproductive Biology and Anaesthetics
Imperial College
St Mary's Hospital
London
UK
利益声明
GR declares that he has no competing interests.
Alexander von Roon, MRCS
Clinical Research Fellow
Department of Biosurgery and Surgical Technology
Imperial College
St Mary's Hospital
London
UK
利益声明
AVR declares that he has no competing interests.
鉴别诊断
- 肛裂
- 克罗恩病
- 溃疡性结肠炎
更多 鉴别诊断指南
- ACG 临床指南：良性肛肠疾病的管理
- 欧洲肛肠病学会痔病指南
更多 指南患者教育信息
肛门撕裂
痔
更多 患者教育信息
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